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目的探讨胃镜介入治疗后联合常规三联疗法治疗消化性溃疡合并上消化道出血的有效性及安全性。方法 70例消化性溃疡出血患者随机分为治疗组和对照组。两组基础治疗相同,并采用静脉注射埃索美拉唑20mg+羟氨苄青霉素1.0g+替硝唑0.5g治疗,治疗组在对照组治疗的基础上,采用内镜注射针注射去甲肾上腺素治疗。测定治疗前及治疗后12、48、72h空腹胃液pH值,评价临床疗效,记录不良反应。结果治疗组临床疗效总有效率为97.1%,明显优于对照组(74.3%),相比较差异有统计学意义(P<0.05)。治疗后12、48、72h两组患者pH值均逐渐升高,与治疗前比较差异有统计学意义(P<0.05);且治疗组pH值升高幅度显著优于对照组(P<0.05)。治疗组再出血发生率和不良反应发生率显著低于对照组(P<0.05)。结论胃镜介入治疗后联合应用埃索美拉唑三联疗法治疗消化性溃疡并上消化道出血临床疗效好,且安全可靠,值得临床推广应用。
Objective To investigate the efficacy and safety of gastroscopic interventional therapy combined with conventional triple therapy in the treatment of peptic ulcer complicated with upper gastrointestinal bleeding. Methods Seventy patients with peptic ulcer bleeding were randomly divided into treatment group and control group. The two groups of the same basic treatment, and the use of intravenous esomeprazole 20mg + amoxicillin 1.0g + tinidazole 0.5g treatment, the treatment group in the control group based on the treatment, endoscopic injection needle injection of norepinephrine treatment. Before and after treatment, the pH value of fasting gastric juice was measured at 12, 48 and 72 hours, and the clinical efficacy was evaluated. Adverse reactions were recorded. Results The total effective rate of the treatment group was 97.1%, which was significantly better than that of the control group (74.3%), the difference was statistically significant (P <0.05). After 12, 48 and 72h treatment, the pH value of both groups increased gradually, with significant difference compared with that before treatment (P <0.05), and the pH value of the treatment group was significantly higher than that of the control group (P <0.05) . The incidence of rebleeding and adverse reactions in the treatment group was significantly lower than that in the control group (P <0.05). Conclusion Gastroscope intervention combined esomeprazole triple therapy for the treatment of peptic ulcer and upper gastrointestinal bleeding clinical efficacy, and safe and reliable, worthy of clinical application.